After numerous cases of waste and abuse in several state
agencies and a major fraud in one of the state’s public
universities, a committee of the state legislature is drafting a
bill to improve accountability in state government. The bill being
proposed would require all state agencies, state colleges and state
universities with over 200 employees to implement an accountability
function. Two approaches to this accountability function are being
considered (1) an Inspector General (OIG) model and (2) an Internal...
Describe the measures required to be implemented to
prevent potential fraud and abuse as it pertains to documentation,
billing, and coding for telehealth services from both the facility
and provider perspective
Given the arguments about how the public sector is different
than the private sector, is it fair for people to complain about
government being slow compared to private firms? Remember to draw
on your readings and the lecture to support your thoughts.
As a health care manager, how would learning about a fraud or
abuse violation in your organization make you feel? How would you
respond professionally to these violations?
You are CEO. Describe how you might use the Fraud Exposure
Triangle to encourage your CFO to "manage" financial reporting to
acheive earnings targets needed for bonus payouts.
Fraud Triangle: Explain what the fraud triangle is. Describe how
the various elements of the fraud triangle play a part in the
occurrence of fraud. How might a manager with knowledge of the
fraud triangle work to reduce the probability of fraud (e.g.,
stress within the workplace)?